Are you being served?

Ellen May has been a regular patient at the Royal Infirmary of Edinburgh for the past 12 years following a triple heart bypass operation in 1987.

Its bad points, she says, are that there is 'no lock on the toilet doors and inadequate space in the women's toilets'. The best bit of her stay in hospital is always 'the young man who brought papers, drinks and sweets to the ward on a trolley'.

Last month, Ms May was one of 200 people asked to record their experience of life at the other end of the stethoscope in three Edinburgh hospitals. Most were interviewed by staff. Ten were given cameras to snap as they went along.

Lothian University Hospitals trust allocated 80 staff for the day to interview patients and their families, capturing their experience of life on the wards at Western General, the Royal Hospital for Sick Children and the Royal Infirmary.

Later this month, a full-scale survey of 5,000 patients will follow, in what the trust believes to be the most ambitious attempt ever conducted in the NHS to view patient care through patients' eyes.

The project was pushed forward by quality manager Dr Pat Straw, who argues: 'The priorities of patients may not be what doctors and nurses believe them to be and this is one method of finding out what really concerns them.'

The project involved 79 wards across the three hospitals and included all ages and all units except intensive care.

Staff asked patients what they liked and disliked about their treatment. As far as possible, they were allocated people they would not usually come into contact with - so clinical staff questioned relatives, while non-clinical staff questioned patients.

Bruce Dickie, planning manager for women's and children's services, was one of the questioners. He says: 'The main concerns patients have are some of the simplest to achieve.

'They want to be called by their first name, they want to know who is treating them and what is going to happen to them. They want to know the name of the nurse treating them and they want to have the same nurse or nurses treating them.

'Many of these patients come in regularly for treatment and they would prefer to build on an existing relationship with someone they had seen before than to be continually having to tell people their name, what their problem is, what are their likes and dislikes.

'Even knowing that nursing and medical staff are quite happy to talk to their relatives about what is happening was an area of concern.

'At least half of these changes are simple procedural changes, which can be implemented immediately.'

Medical director Dr Charles Swainson argues that the concerns voiced by patients about toilet doors and newspapers bear out his own views. 'People seldom have concerns about the quality of their treatment in terms of the operation they have, or the medical care they receive,' he says.

'What they are often concerned about are the simple issues such as knowing their doctor's name, what treatment are they being given, and the amount of information they receive,' he says.

'They want to be involved in their care and there is a whole range of simple things we can do to ensure that they feel more involved in their treatment.

'This is about raising staff awareness of what patients feel about their treatment, and trying to give them what they want rather than what we think they want.'

Financial penalties are being lifted from high-profile standards including cancer and elective waiting times, so far without attracting much attention. How is this happening? And will it work, asks Rob Findlay